By Colin Michie FRCPCH FRSPH FLS RNutr FRSA
Physically, we have some things in common with all the microbes, plants, fungi, fishes and animals around us – we are all built on the molecules we breathe, eat and drink. Your backyard limes grow containing water from St. Maarten’s rains, just as does your blood.
A new-born infant grows from its milk feeds. And during early growth, the brain sprints ahead of other organs, doubling in size in the first year of life. Milk is a living fluid, unique to each mother, containing cells, antibodies and molecules that feed and protect her infant. Specific fats, sugars, proteins and micronutrients together with protective molecules and particles effectively vaccinate an infant against the organisms she has met. Mother’s milk promotes brain development, reduces the risks of obesity and cardiovascular disease in adulthood. For mothers, breastfeeding reduces the risks of breast and ovarian cancer, osteoporosis, cardiovascular disease and obesity. For both, breastfeeding creates a strong emotional bond.
Mothers tailor their milk feeds for their infants. So seal milk has a very high fat content, ensuring a seal pup develops insulating skin blubber. Kangaroos produce different milks depending on the size of the joey. Rodents secrete very high protein milks to promote rapid growth of their pups. Bovine milk is designed for rapid musculoskeletal growth in a calf. In all mammals, the risk of dying is highest for the new-born as a result of malnutrition and infection. This is true, too, for our species: success in lactation can be challenging and is not always possible.
The lack of preparation during pregnancy, wise support and often painful mastitis can be particularly challenging for a first-time mother. Infants too can be difficult feeders. Having once received a high flow formula feed from an artificial teat, babies are likely to be slow to return to breastfeeding – this requires more active sucking. A working mother’s lifestyle can limit mother’s breastfeeding – expression and refrigeration allows many to manage.
These situations are not new. Wet nurses have traditionally been invaluable community supports. The wet nurse who feeds your infant becomes a family relative in recognition of this important tie in several cultures – the Arabic language for breastmilk translates to “white blood”. Wet nursing requires care as several viruses may be transmitted in milk, potentially compromising an infant’s health. Milk banks selling pasteurised human milk from carefully screened donors provide a growing service in over 60 countries. Banked milk now saves the lives of many premature infants in particular, thanks to this innovation.
Archaeologists have unearthed devices used to feed infants artificially from many ancient urban centres. Through history, milks collected from cows, sheep, goats, camels, yaks, horses, donkeys and reindeer have all been used to feed babies. Centuries ago, Dutch women working long hours in urban factories used raw cow’s milk for several infant feeds a day. Infants fed raw milks and colostrum from animals may show benefits: these being intensively studied. Processed formula milks, however, pose hazards when compared with mother’s milk. They increase the rates of allergies, food intolerances and gut diseases.
Why are expensive formula milks so popular, given their disadvantages? Pervasive and aggressive advertising of breast-milk substitutes by milk companies for over 50 years is probably a significant contributor. Although it violates a 1981 international code, advertising formula is now embedded into social media under many guises. Over half of parents and mothers are exposed to the insidious marketing of breast-milk substitutes.
Economic and planetary health enter into the balance too. Longer periods of exclusive breast-feeding and a stopping unnecessary “follow-on” milk feeds for weaning will reduce health care costs. The carbon footprint of formula feeds is high: estimated as greater than 95 kg of carbon dioxide per infant. Food waste related to formula production, distribution and marketing is significant. Changing our diets and those of our infants are particularly powerful weapons to influence the patterns of climate change.
When a formula milk factory closed in Michigan this year, after the deaths of two infants and the hospitalisation of two others who had consumed their product, the remaining manufacturers could not keep up. The resulting formula shortage impacted working mothers. Many countries find lower breast-feeding rates among those living in socioeconomically deprived areas. Children have a right to good nutrition, wherever they are born and whatever the situation of their mothers. Societies, employers and neighbours can develop better supports for pregnant and nursing mothers so they do not have to choose the convenience and risks of formula feeds. This is biological logic.
Our ancestors struggled to get us here. Why compromise our next generation’s health and that of our planet with processed products?
Background:
https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
https://www.unicef.org.uk/babyfriendly/
https://www.who.int/news-room/facts-in-pictures/detail/breastfeeding#:~:text=WHO recommends that: mothers initiate breastfeeding within; continue for up to two years or beyond.
